Decision Ready Claims Program Hindered by Ineffective Planning

The VA Office of Inspector General (OIG) conducted this review to determine whether the Veterans Benefits Administration (VBA) effectively planned and implemented the Decision Ready Claims (DRC) program. The DRC program was intended to streamline the processing of veterans’ claims applications by allowing veterans to work with an accredited representative, such as a veterans service organization representative, who assists in gathering all the evidence needed for VA to decide the claim. VBA developed the DRC program with a goal to complete claims within 30 days. However, VBA completed only 1,803 claims by September 2018, far short of VBA’s expectations. The OIG found that VBA did not effectively plan the DRC program. VBA leaders did not fully consider historical data from a similar program as a benchmark when defining program goals. Also, VBA did not obtain broad acceptance from key stakeholders needed to implement the process, nor did it ensure information technology system functionality to allow representatives or veterans access to the system to manage VA records and benefit claims. Furthermore, VBA contravened the plain language of federal statutes and regulations by obligating and expending funds for contract medical examinations before receiving claims from veterans. VBA decided to end the DRC program in February 2019. Although the OIG did not make recommendations related to VBA’s ineffective planning, the examples provided should be instructive for other new initiatives. The OIG recommended the Under Secretary for Benefits work with the VA Secretary and Chief Financial Officer to determine whether any Antideficiency Act violations occurred, and if so, address these violations.